请简单说明领取应急口罩的原因，例如家中没有或几乎没有口罩，替邻居老人领取，等等。 Please briefly explain the urgent reasons you're requesting these masks, for example, masks in the household run out or almost run out, requesting the masks on behalf of the senior(s) next door, etc. *

Your answer

免责声明 Waiver *

In consideration for accepting voluntarily the free masks mentioned above, I/we hereby RELEASE, WAIVE, DISCHARGE AND COVENANT NOT TO SUE, the Belmont Chinese American Association and its volunteers from any and all liability, claims, demands, actions and causes of action whatsoever arising out of or related to any loss, damage, or injury, including death, that may be sustained for using the masks.